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RAPID DIAGNOSTIC CLINIC

RAPID DIAGNOSTIC CLINIC. Head and Neck SSG Sept 2019 Dr Mandy Williams Head and Neck Radiology Cons. Current service. 4Hr NLC – Max facs. BDH with radiology and pathology cover. 12 new px 1.5-2hr ENT NLC-St Michaels. Radiology only. 8-12 new px. USS lists. 8 USS lists at BDH

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RAPID DIAGNOSTIC CLINIC

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  1. RAPID DIAGNOSTIC CLINIC Head and Neck SSG Sept 2019 Dr Mandy Williams Head and Neck Radiology Cons

  2. Current service • 4Hr NLC – Max facs. BDH with radiology and pathology cover. • 12 new px • 1.5-2hr ENT NLC-St Michaels. Radiology only. • 8-12 new px.

  3. USS lists • 8 USS lists at BDH • 1.5-NLC- 5 slots Tues pm SMH/ 10 BDH Fri am • 85 other USS slots. Under using NLC slots. Ave for St Michaels July/Aug-2 scans week(50% biopsy . 20 USS/10 biopsies. BDH- Aug 11/40 USS, July 24/40 11 biopsies ( 1/3rd had biopsy).

  4. Current problems • Fast track patients with neck lumps not always seen in specialist clinics. • SMH- USS remote from clinic and no pathology cover. • Variable numbers of USS/ biopsies. • 2WW USS often seen on lists without pathology cover/ inadequate samples. • Clinics cancelled / reduced when Head and Neck Cons on leave even if radiology/pathology cover available • Difficult to know from 2ww referral which need USS.

  5. Rapid diagnostic Clinic • Aims • Patients with high suspicion of malignancy to be seen quickly for USS biopsy with immediate pathology assessment. • Referrals primarily from ENT/Max facs. • Seen same week for biopsy. • Preliminary cytology report same day/ 24 hrs. • Aid staging scans/ reduced time to diagnosis.

  6. Logistics • 18 slots available on Friday morning. • Clinic based at BDH as access to USS and cytology. • 2 Radiology Cons/ 1 pathology Cons.

  7. Patient journey • 2ww referral from GP: • Seen in ENT/Max facs specialist clinic. • If high clinical concern of cancer request for neck ultrasound put on ICE. • Patient given information leaflet

  8. BDH- go to xray reception and immediately book appointment for Friday clinic. • ENT- nurse to ring dental Xray reception and will immediately be given an appointment. • Patient arrives later the same week for USS and biopsy if needed. • Follow up in ENT/Max Facs 1-2 weeks later with results and staging.

  9. Low risk patients • If after assessment low risk of cancer but needs an USS this is requested in normal way on ICE and patient will be seen on other USS clinic either urgent ( 3-4 weeks) or routine –within 6 weeks

  10. Still to do • Identify clinic room at BDH and install PACS points and install soft ware for CRIS/PACS • Identify USS lap top to use for pilot/ 3 months • Ensure dental nursing cover for 2 lists • Finalise patient leaflet.

  11. Questions?

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